Dr. Diane McIntosh

Psychiatrist and clinical assistant professor at the University of British Columbia

Dr. McIntosh graduated from Dalhousie University, where she completed an undergraduate degree in pharmacy before completing medical school and a psychiatry residency. She is a clinical assistant professor at the University of British Columbia, has a busy private practice and presents continuing medical education programs to colleagues nationally and internationally, with a focus on rational pharmacology.

Dr. McIntosh has a particular interest in the neurobiology of mood and anxiety disorders. She sits on the Board of Directors of CANMAT, the Canadian Network for Mood and Anxiety Treatments and the Advisory Board for CADDRA, the Canadian ADHD Research Alliance.

Mental illness has always been highly stigmatized. Mental Health Month and other awareness programs attempt to bring mental illness out of the shadows, yet many of those who should be leading the fight to de-stigmatize mental illness, my fellow physicians, continue to foster stigma through their actions and words. Many patients have been irreparably harmed by physicians from every area of medicine who don't read, don't listen, and don't care about mental illness.

Many believe pharmaceutical companies are repugnant. There were several serious issues that built the foundation of the anti-pharma movement. While not all companies are guilty or equally responsible, many behaved unethically. They didn't always fully disclose research and safety data if it didn't support their product. They attempted to prevent researchers from voicing serious concerns. They created inappropriate relationships with physicians, leaving the impression that doctors were being bought, and sometimes that was true. This had to change.

The diagnosis of PTSD requires that a person has "...experienced, witnessed or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others." The traumatic event must provoke intense fear, helplessness, or horror.

Panic disorder is associated with anxiety that continues after the panic attack has resolved. Patients with panic disorder worry about having another attack or that they might lose control. Sometimes they fear they're suffering from a serious medical condition that hasn't been diagnosed. As a result, they change their behavior to avoid situations that might provoke another attack.

Some physicians are writing thousands of cannabis prescriptions every year for a wide variety of maladies. Many of their "patients" are not adequately assessed, nor are they informed about or encouraged to try conventional treatment options, which often have far more evidence for their safety and efficacy. Their "patient" wants cannabis and they get cannabis.

Why do some teens find those years more challenging than others? Why do some teens make ridiculous, dangerous or inexplicable choices? One significant factor is rooted in brain development, a critical aspect of normal maturation. Unfortunately, sometimes brain development goes awry during adolescence resulting in mental illness.

It pains me to hear the nonsense my patients are subjected to by sometimes well-meaning, yet utterly uninformed, self-taught mental health experts. Their lack of scientific training is merely a preamble ("I'm no doctor but..."). They speak with enthusiasm and authority as they peddle supplements, homeopathic tinctures, detox enemas and antioxidant smoothies, with the goal of liberating my patients from their evidence-based treatments and dollars from their wallets.

The trouble is, there is no recipe book for prescribing psychiatric medications. Every individual is unique, so with the guidance of their doctor, patients must find the treatment that's right for them. If a drug makes them feel worse, it's not the right drug, but that doesn't mean there are no other options. The right treatment must be found and sometimes that takes time, effort and creativity. Feeling like a zombie is never an acceptable outcome.

Riley, a fictitious patient, was first depressed in high school. "I remember not caring about anything. I didn't see my friends. I just wanted to sleep. I seriously considered suicide. I had always be...

Depression is a libido killer. Our brain is our most important sexual organ and a depressed brain may cause a complete loss of sexual interest and make it difficult, sometimes impossible, to get or sustain an erection or have an orgasm. As depression resolves, usually sexual dysfunction resolves as well.

Depression is horrible and sometimes it's deadly. Data from the World Health Organization demonstrates this serious public health issue. Yet depression is misunderstood by those who have never experienced it because they can't understand why depressed people don't just will themselves better.

There is no single cause for schizophrenia. THC alone is not responsible, but there is an abundance of evidence that THC can provoke an earlier onset of schizophrenia by up to six years. There is also solid evidence to suggest a causal link between THC and schizophrenia.

Schizophrenia is a complex and often devastating illness, characterized by the presence of psychotic symptoms including delusions, hallucinations, disorganized thinking and behaviour and negative symptoms (apathy, lack of motivation, social withdrawal, and reduced emotional responsiveness).

Physicians have not effectively confronted pot-related myths, nor have we adequately educated our patients. When I tell parents about marijuana's risks, they often express shock. Many believe it's like oregano... a safe "natural product" that adds a little spice to life. But pot is not benign.

I have heard the question, "Are you saying it's all in my head?" countless times, so I now begin discussions about physical symptoms associated with depression and anxiety with, "Just because your symptoms aren't caused by an injury or an infection doesn't mean they're not real."

I tell my patients, "Mental illnesses are medical illnesses, like diabetes or heart disease." Most of them struggle to believe me because they know that many people, even people who love them, think they can just "get over" their illnesses. And they're equally as hard on themselves. So let's talk about what causes mental illness, and why that question (and answer) are pretty complicated.

The debate about whether it's appropriate and safe to treat attention deficit hyperactivity disorder (ADHD) is the psychiatry equivalent of the childhood vaccine debate in pediatrics. In both cases, the science is abundant and clear: vaccines and ADHD treatments are safe and effective.

The debate about whether it's appropriate and safe to treat attention deficit hyperactivity disorder (ADHD) is the psychiatry equivalent of the childhood vaccine debate in pediatrics. In both cases, the science is abundant and clear: vaccines and ADHD treatments are safe and effective.

So why wouldn't mental health professionals want to talk to these families? Too often it is due to a misguided sense of the rules regarding confidentiality. Sometimes mental health care teams are over-extended and don't want to deal with the expectations of family members. Excluding family from important decision-making discussions leaves them frustrated and demoralized and is often not in the patient's best interest.